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HIV Testing and Treatment With Correctional Populations: People, Not Prisoners

Author

Seal, David Wyatt

Eldridge, Gloria D

Zack, Barry

Sosman, James

Bibliographic Citation

Journal of health care for the poor and underserved 2010 Aug; 21(3): 977-85

Abstract

Institutional policies, practices, and norms can impede the delivery of ethical standard-of-care treatment for people with HIV in correctional settings. In this commentary, we focus on the fundamental issues that must be addressed to create an ethical environment in which best medical practices can be implemented when working with correctional populations. Thus, we consider ethical issues related to access to services, patient privacy, confidentiality, informed consent for testing and treatment, and issues related to the provision of services in an institutional setting in which maintenance of security is the primary mission. Medical providers must understand and navigate the dehumanization inherent in most correctional settings, competing life demands for incarcerated individuals, power dynamics within the correctional system, and the needs of family and significant others who remain in the community.

The incarcerated population has increased to unprecedented levels following the 1970 US declaration of war on illicit drug use. A substantial proportion of people with or at risk for HIV infection, including those with ...